Project Summary: Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics (PVDOMICS). Pulmonary Vascular Disease (PVD) is a poorly understood but lethal condition. Currently, pulmonary hypertension (PH) is nosologically divided into Groups associated with primary vascular abnormalities, left-sided heart failure, pulmonary parenchymal and thromboembolic diseases. It is likely that these different forms of PH share common mechanistic pathways leading to PVD that might be targeted therapeutically, but currently these ostensible shared mechanisms remain poorly understood. In order to better understand the fundamental mechanisms of PVD in PH, this application seeks to enroll large numbers of people with each form of PH and perform detailed phenotyping of clinical, hemodynamic, functional, biomarker, metabolomic, and proteomic patterns.